动脉瘤支架辅助栓塞术后应用替罗非班致血小板减少1例
A Case of Thrombocytopenia Induced by Tirofiban after Stent-Assisted Embolization for Aneurysm
DOI: 10.12677/acm.2025.1541067, PDF,   
作者: 周光文, 田泰宇, 朱 甜, 李智恒：吉首大学医学院，湖南 吉首；田 志*：吉首大学第一附属医院神经外科，湖南 吉首
关键词: 血小板减少；动脉瘤破裂；替罗非班；病例报告；Thrombocytopenia； Ruptured Aneurysm； Tirofiban； Case Report
摘要: 1例左侧后交通动脉瘤破裂伴蛛网膜下腔出血患者急诊行全脑血管造影术 + 颅内动脉瘤支架辅助栓塞术术中予盐酸替罗非班后出现极重度血小板减少症，最低血小板计数为1 × 109/L。在停用该药后及对症治疗后血小板逐渐恢复，继续予以阿司匹林肠溶片、硫酸氢氯吡格雷预防血栓，最终好转出院。
Abstract: A patient with a ruptured left posterior communicating artery aneurysm accompanied by subarachnoid hemorrhage underwent emergency cerebral angiography and intracranial aneurysm stent-assisted coiling. During the procedure, administration of tirofiban hydrochloride induced profound thrombocytopenia, with the lowest platelet count dropping to 1 × 109/L. Following discontinuation of the medication and symptomatic treatment, platelet levels gradually recovered. Thrombosis prophylaxis was maintained with enteric-coated aspirin tablets and clopidogrel bisulfate. The patient ultimately improved and was discharged.
文章引用：周光文, 田泰宇, 朱甜, 李智恒, 田志. 动脉瘤支架辅助栓塞术后应用替罗非班致血小板减少1例[J]. 临床医学进展, 2025, 15(4): 1366-1369. https://doi.org/10.12677/acm.2025.1541067

参考文献

[1] Al-Salihi, M.M., Ayyad, A., Al-Jebur, M.S., Al-Salihi, Y., Saha, R., Morsi, R.Z., et al. (2023) Safety and Efficacy of Tirofiban in the Management of Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Clinical Neurology and Neurosurgery, 232, Article ID: 107867. [Google Scholar] [CrossRef] [PubMed]
[2] Kim, S.H., Kim, T.G. and Kong, M.H. (2017) Intra-Arterial and Intravenous Tirofiban Infusion for Thromboembolism during Endovascular Coil Embolization of Cerebral Aneurysm. Journal of Korean Neurosurgical Society, 60, 518-526. [Google Scholar] [CrossRef] [PubMed]
[3] 许俊堂. 肝素诱导的血小板减少症中国专家共识解读[J]. 中国循环杂志, 2018, 33(S2): 117-20.
[4] Piao, B., Li, T., Zhong, H., Yang, H., Wang, Y. and Liu, H. (2023) Acute Profound Thrombocytopenia Induced by Tirofiban in Stent Assisted Embolization of Intracranial Ruptured Aneurysm—A Rare Case Report. Heliyon, 9, e14504. [Google Scholar] [CrossRef] [PubMed]
[5] 陈智勇, 闫小响. 替罗非班引起的血小板减少症相关分析[J]. 中国动脉硬化杂志, 2022, 30(7): 633-9.
[6] 华倚虹. 替罗非班相关的血小板减少症诊治流程及病例分析[J]. 中国介入心脏病学杂志, 2015, 23(1): 48-50.
[7] Naranjo, C.A., Shear, N.H. and Lanctôt, K.L. (1992) Advances in the Diagnosis of Adverse Drug Reactions. The Journal of Clinical Pharmacology, 32, 897-904. [Google Scholar] [CrossRef] [PubMed]
[8] Li, Y., Cui, R., Fan, F., Lu, Y., Ai, Y., Liu, H., et al. (2022) The Efficacy and Safety of Ischemic Stroke Therapies: An Umbrella Review. Frontiers in Pharmacology, 13, Article ID: 924747. [Google Scholar] [CrossRef] [PubMed]
[9] 刘晓丽, 彭萍安, 程宇婧. 血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂在冠状动脉粥样硬化性心脏病治疗的中国专家共识(2016) [J]. 心肺血管病杂志, 2016, 35(12): 923-932.
[10] 任静, 杜晖, 郑瑶, 等. 替罗非班致血小板减少症临床病例分析[J]. 药物流行病学杂志, 2021, 30(5): 314-316+325.
[11] 蔡增林. 替罗非班联合双联抗血小板治疗颅内动脉瘤的安全性[J]. 中国卒中杂志, 2020, 15(8): 904-906.
[12] Zhou, J., Gao, Y. and Ma, Q.L. (2020) Safety and Efficacy of Tirofiban in Acute Ischemic Stroke Patients Not Receiving Endovascular Treatment: A Systematic Review and Meta-Analysis. European Review for Medical and Pharmacological Sciences, 24, 1492-1503.

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